| NPI | 1477941722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F306443) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 591905) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NY F340912) | |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2018-10-30 |